Many have heard the word “gluten” and with the increased trend of gluten free diets it’s important to understand what it is, what it does, who the gluten free diet applies to and how gluten containing grains contribute to our health.
Here, nutritionist Laurann O’Reilly and owner of Nutrition by Laurann explains everything you need to know about gluten.
- What is Gluten? - Gluten is made of seed storage proteins called gliadin and glutenin which are found in rye, barley, spelt, triticale, wheat and derivatives of wheat such as durum (commonly used for pasta) and semolina and oats (with gluten free or “pure” oats being the exception).
- Gluten in Food Production & Manufacture - From a food science perspective gluten plays an important role in the production of pasta and baked goods through acting as a binding agent, providing elasticity and influencing the texture of foods.
- Coeliac Disease - Unlike an allergy or an intolerance, the Celiac Disease Foundation describes coeliac disease as “an autoimmune disease where the ingestion of gluten leads to damage in the small intestine”.
It is often hereditary in that it runs in the family also.
- Statistics - According to the Coeliac Society of Ireland “there are an estimated 50,000 people living with coeliac disease in Ireland, and a further 400,000 who are gluten intolerant”.
Whilst the Coeliac Disease foundation states that it “is estimated to affect 1 in 100 people worldwide”.
- Symptoms - Some of the symptoms may include severe or occasional diarrhoea, excessive wind and/or constipation, persistent or unexplained nausea and vomiting, recurrent stomach pain, cramping or bloating, any combination of iron, vitamin B12 or folic acid deficiency, anaemia, fatigue/tiredness, unexpected weight loss/gain (but not in all cases), mouth ulcers or a skin rash.
Note: Please contact your GP if you have the above symptoms. You can also take the Coeliac Society of Ireland assessment here (it is recommended that if you are under the age of 16 to do so with a parent, carer or guardian) https://www.isitcoeliacdisease.ie/
- Diagnosis - If you suspect that you may have coeliac disease you can request a blood test from your GP.
The Coeliac Society of Ireland recommends “to be on a gluten-containing diet before testing in order to ensure the most accurate result” and that “four slices of ordinary bread a day for six weeks or more should be sufficient”.
Please note that self-diagnosis is not recommended as a formal diagnosis as it is important to ensure you are not eliminating gluten unnecessarily and so that you get the right guidance in terms of management from your health professional.
- Avoiding Gluten Cross Contamination - For those who are coeliac even the smallest amount of gluten can cause symptoms. Whether you are coeliac, someone in your household is, you are preparing food for someone with a gluten sensitivity or you are a business who provides gluten free options, avoiding gluten cross contamination is important.
The Coeliac Society of Ireland has just recently published some helpful guidelines which includes:
1) Cleaning: “Dry wipe with a disposable towel to remove visible crumbs prior to cleaning. Use a thoroughly cleaned area for gluten free preparation”.
2) Use separate utensils where possible and “if this is not possible, wash the utensils thoroughly with hot water and washing up liquid/dishwasher between tasks”,
3) “Always wash your hands before preparing gluten free food and between tasks”,
4) “Store gluten free foods separately and above gluten containing foods, label clearly and wrap well”,
5) “To make gluten free toast keep a separate toaster or use toaster bags for the gluten free bread”
6) “Keep separate jars of jams, condiments and separate butter/spread for use by person avoiding gluten”,
7) “Do not fry gluten free foods/chips in fryers used for frying gluten containing crumbed or coated foods” as it contaminates the gluten-free product,
8) “If possible cook gluten free foods in a separate oven, otherwise cook the gluten free foods on the shelf above the other food” and cover with tinfoil as gluten can remain airborne.”
Support: If you suspect you may be coeliac or gluten intolerant you can contact your GP. You can also get helpful support and advice from the Coeliac Society of Ireland who aim to “empower the entire coeliac and gluten intolerant community by providing them with information, advice and practical solutions as they navigate a gluten-free lifestyle” at www.celiac.ie
- Non Coeliac Gluten Intolerance/Sensitivity - An article in the United European Gastroenterology Journal describe non-coeliac gluten sensitivity (NCGS) as a condition where intestinal and extraintestinal symptoms are triggered by gluten ingestion in the absence of coeliac disease and wheat allergy.
Whilst the symptoms may not be as severe as those in coeliac disease, individuals with NCGS may be required to eliminate gluten. Unfortunately, NCGS is still unclear and much remains unknown about the condition. Note: It’s always best to contact your GP or health professional if you suspect you may have a sensitivity to gluten.
- Unnecessary Gluten Avoidance - Following a gluten free diet can often be unnecessarily restrictive if you are not required to do so.
As the gluten containing grains are a valuable source of nutrition it’s not recommended that you eliminate gluten unless you have been recommended to do so by a health professional.
According to an article published in Nutrition Bulletin, bread provides:
11-12% of energy
16-20% of carbohydrates
10-12% of protein
17-21% of fibre
As well as being an important source of the minerals containing:
9-14% of folate
15-17% of iron
12-17% of calcium
12-13% of magnesium
10-11% of zinc
- Natural Gluten Free Foods or Alternatives - If you have been recommended to eliminate gluten from your diet or you are preparing a meal for someone on a gluten free diet, here are some naturally gluten free foods or alternatives which you can choose.
Rice – Is a great source of nutrition, is a great source of plant based protein and can be easily incorporated into lunches, main meals, rice cakes are a handy snack and rice is often found as an ingredient in gluten free breads.
Corn- A great and versatile ingredient, it’s great for thickening soups, in cereals, used as an ingredient in gluten free breads and popcorn is a great gluten free snack too.
Gluten Free Oats or ‘Pure Oats’ - As it turns out oats don’t traditionally contain gluten, but may be exposed to gluten during the manufacturing process. Look for gluten free or ‘pure oats’ which provide a nutritious breakfast.
Quinoa - It isn’t a grain crop but rather a pseudocereal (a non-grasses that is used in much the same way as cereals).
It’s a great source of plant based protein and one of the few plant foods that contain sufficient amounts of all nine essential amino acids.
It’s also rich in minerals and vitamins, antioxidants and omega 6. It’s quite versatile in that it can be used for breakfast, as a side dish or cold as a salad.
Buckwheat - Whilst buckwheat is often thought of as a cereal grain, it is actually a fruit seed.
This is a great versatile ingredient which can be used for breakfast (buckwheat flakes) and can also come in the form of pasta (handy for main meals) and crispbreads which make a great gluten free cracker alternative.
Sorghum - This is one that many may not have heard of, although it’s more like a grain it belongs to the grass family.
It’s surprisingly nutritious and can be used in gluten free baking as well as in gluten free breakfast cereals such as ‘Nutribrex’ an alternative to Weetabix.
Millet - Another grain which belongs to the grass family. Being a great source of plant based protein, fibre and antioxidants it’s a great ingredient for use in breads, cereals and in main meals.
About Laurann: Laurann O’Reilly is qualified and experienced Nutritionist with a BSc. Degree in Human Nutrition from University of Nottingham and a Master’s in Public Health Nutrition from University College Dublin. She has over 10 years of experience including working community and clinical care, research, personalised nutrition consultations (dealing in healthy eating, weight loss, digestive health and sports nutrition), teaching and developing nutrition courses at FETEC level, nutrition education talks and workshops (corporate wellness, schools, sports teams, public and private talks), previous food manager of the Coeliac Society of Ireland and is part of the roll out team for the Healthy Ireland Smart Start health promotion programme for pre-schools.
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